minimally verbal
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Author(s):  
Melanie Palmer ◽  
Joanne Tarver ◽  
Virginia Carter Leno ◽  
Juan Paris Perez ◽  
Margot Frayne ◽  
...  

AbstractEmotional and behavioral problems (EBPs) frequently occur in young autistic children. Discrepancies between parents and other informants are common but can lead to uncertainty in formulation, diagnosis and care planning. This study aimed to explore child and informant characteristics are associated with reported child EBPs across settings. Participants were 83 4–8-year-old autistic children and their parents and teachers in the Autism Spectrum Treatment and Resilience (ASTAR) study. Questionnaires of child EBPs were completed by parents and teachers, and self-reported parenting stress and wellbeing measures were obtained. An observation of parent–child/researcher-child interaction was also completed. Parents reported more EBPs than teachers and parent-teacher agreement was low, particularly for emotional problems. Greater parenting stress and being verbal was associated with more parent- but not teacher-reported EBPs. More observed behaviors that challenge were displayed by minimally verbal children. More parenting stress could be associated with the presence of more EBPs in the home; alternatively, parenting stress may confound reports. It is essential for assessments of EBPs in autistic children to take a multi-informant approach. Better understanding of the associations between informant characteristics and informant discrepancies of EBPs is needed.


2022 ◽  
Vol 14 (1) ◽  
Author(s):  
Rebecca Shaffer ◽  
Angela John Thurman ◽  
Lucienne Ronco ◽  
Diego Cadavid ◽  
Shane Raines ◽  
...  

Abstract Background Social communication is a key area of difficulty in fragile X syndrome (FXS) and there are not yet adequate outcome measurement tools. Appropriate outcome measures for FXS have been identified as a key area of research interest in order to evaluate future therapeutic trials. The Brief Observation of Social Communication Change-Minimally Verbal (BOSCC-MV), an outcome measure with strong psychometrics developed for autism spectrum disorder, has promise as an outcome measure to assess social communication change with FXS participants. Methods We examined the BOSCC-MV via central coders in this multi-site-trial to assess its appropriateness for FXS. Eighteen minimally verbal males ages 3–12 years were enrolled and assessed on two consecutive days and 7 participants completed a third visit 6 months later. We examined test-retest reliability, inter-rater reliability, and both convergent and divergent validity with standard clinical measures including the Autism Diagnostic and Observation Schedule-2, Vineland 3, Social Responsiveness Scale, and the Aberrant Behavior Checklist. Results The BOSCC-MV in FXS demonstrated strong inter-rater and test-retest reliability, comparable to previous trials in idiopathic ASD. Strong convergent validity was found with Autism Diagnostic Observation Schedule-2 and Vineland-3. Divergent validity was demonstrated between BOSCC-MV and unrelated measures. Conclusions The BOSCC-MV shows promise as a FXS social communication outcome measure, warranting further large-scale evaluation.


2022 ◽  
Vol 40 ◽  
Author(s):  
Annio Posar ◽  
Paola Visconti

ABSTRACT Objective: To review clinical and neurobiological features of minimally verbal children with autism spectrum disorder. Data source: We carried out a narrative review using the PubMed database. We considered the following search terms combined through the Boolean operator “AND”: “autism spectrum disorder”; “minimally verbal.” Data synthesis: To date, there is no shared definition of minimally verbal children with autism spectrum disorder. The heterogeneity in intellectual functioning and in linguistic abilities among these individuals suggests there is no single mechanism underlying their difficulties in learning to speak. However, the reasons why these children do not speak and the biological markers that can identify them are still unknown. Language impairment in these children can lead to several unfavorable consequences, including behavior problems (such as self-aggression, hetero-aggression, and property destruction), poorer daily living and social skills. Psychiatric comorbidities (including attention deficit/hyperactivity disorder, specific phobias, and compulsions) consist in a serious problem related to the lack of verbal language in individuals with autism spectrum disorder. Although in the literature there are very few evidence-based results, several findings suggest that an alternative and augmentative communication intervention, creating an extra-verbal communication channel, may be effective in these individuals. Conclusions: The exact definition, clinical characteristics, associated disorders, etiology, and treatment of minimally verbal subjects with autism spectrum disorder must still be further studied and understood.


2021 ◽  
Author(s):  
◽  
Alicia Marie Bravo

<p>Autism Spectrum Disorder (ASD) is characterized by marked deficits in communication and social skills in addition to restricted interests and repetitive behaviour. Children with ASD have also been reported to have significant deficits with respect to their ability to repair communication breakdowns. To date, assessments targeting communication repair strategies in children with ASD have been limited in number and lack consistency of implementation. For the current research, both an indirect and direct assessment have been developed to investigate the repair repertoires of primary school-aged children who were minimally verbal. Indirect assessments were conducted with each of the participant’s teachers, and the direct assessments were conducted by creating breakdown scenarios during a requesting routine and recording if and how the children attempted to repair the communication breakdown. Results show that children tended to rely on a singular repair strategy involving the repetition of their initial request. An intervention program was then developed and evaluated with two of the children. These children were taught to use an iPad®-based speech generating device to repair communication breakdowns that occurred when the children’s initial request was followed by receipt of the wrong item. The intervention was evaluated using a nonconcurrent multiple baseline experimental design. Each of the participants showed an increase in responding under specific communication breakdown conditions. While this research is quite preliminary, the data suggests that repair repertoires of children with ASD can be assessed via a structured, direct asses and improved with interventions based on the assessment results.</p>


2021 ◽  
Author(s):  
◽  
Alicia Marie Bravo

<p>Autism Spectrum Disorder (ASD) is characterized by marked deficits in communication and social skills in addition to restricted interests and repetitive behaviour. Children with ASD have also been reported to have significant deficits with respect to their ability to repair communication breakdowns. To date, assessments targeting communication repair strategies in children with ASD have been limited in number and lack consistency of implementation. For the current research, both an indirect and direct assessment have been developed to investigate the repair repertoires of primary school-aged children who were minimally verbal. Indirect assessments were conducted with each of the participant’s teachers, and the direct assessments were conducted by creating breakdown scenarios during a requesting routine and recording if and how the children attempted to repair the communication breakdown. Results show that children tended to rely on a singular repair strategy involving the repetition of their initial request. An intervention program was then developed and evaluated with two of the children. These children were taught to use an iPad®-based speech generating device to repair communication breakdowns that occurred when the children’s initial request was followed by receipt of the wrong item. The intervention was evaluated using a nonconcurrent multiple baseline experimental design. Each of the participants showed an increase in responding under specific communication breakdown conditions. While this research is quite preliminary, the data suggests that repair repertoires of children with ASD can be assessed via a structured, direct asses and improved with interventions based on the assessment results.</p>


2021 ◽  
Author(s):  
Dominique Girard ◽  
Valérie Courchesne ◽  
Catherine Cimon-Paquet ◽  
Claudine Jacques ◽  
Isabelle Soulières

Abstract Background The question of cognitive prognosis is frequently asked at the time of autism diagnosis, often at preschool age. It remains however difficult to answer this question at such a young age, given the considerable heterogeneity of cognitive development trajectories and the challenges associated with intellectual assessment in autistic children, particularly among minimally verbal children. Methods The current prospective cohort study investigated whether early perceptual abilities measured at preschool age could predict later intellectual abilities at school age in a group of 41 autistic (9 girls, 32 boys) and 57 neurotypical children (29 girls, 28 boys). Participants were assessed at three time points during the childhood period (between the age of 2 and 8 years old) using the Wechsler Preschool and Primary Scales of Intelligence – Fourth edition as a measure of full-scale IQ and the Raven’s Colored Progressive Matrices as a measure of non-verbal IQ. The performance on two perceptual tests (Visual Search and Children Embedded Figures Test) as well as the frequency of perceptual behaviors served as predictors of later intellectual abilities. Results Early performance on perceptual tests measured at preschool age was positively related to later full-scale IQ in both autistic and neurotypical children. Furthermore, both perceptual behaviors and performance on perceptual tests measured at preschool age were associated with later non-verbal IQ in the autistic group. In contrast, only the performance on Children Embedded Figures Test was associated with later non-verbal IQ in the neurotypical group. Limitations: The sample size was relatively modest, with some attrition across time points, as expected in a sample including preschool minimally and non-verbal children. Conclusions Our findings support the important role of perception in autistic cognition. Early perceptual abilities may be a valid avenue for estimating general intelligence and non-verbal abilities at preschool age, particularly for minimally verbal autistic children.


2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Tim I. Williams ◽  
Tom Loucas ◽  
Jacqueline Sin ◽  
Mirjana Jeremic ◽  
Georgia Aslett ◽  
...  

Abstract Background About 30% of children with autism spectrum disorder (ASD) do not develop functional speech and remain non-verbal or minimally verbal even after years of speech, language and educational interventions. A wide range of interventions have been developed for improving communication in ASD, but none have proved effective in eliciting functional language in ASD children. Research has found that people with ASD are more likely to have perfect pitch and prefer music to language. Further, it seems that language delay tends to co-occur with better musical skills. Brain imaging research has found that music alongside words increases the attention that people with ASD pay to spoken words. Methods In this protocol, we describe our music-assisted programmes (MAP) that will use music to attract the attention of people with ASD to speech. MAP may open the brain pathways to language and therefore help improve communication skills for people with ASD more than standard communication protocols. In particular, we aim to develop and test whether individualised, easily used MAP would increase spoken language in 24–60-month-old, nonverbal or minimally verbal children with ASD. We will develop a structured training method, delivered through naturalistic, interactive activities (e.g. songs) to teach language to ASD children. We will test this by comparing two groups: one undertaking music-assisted programmes, and the other receiving speech and language therapy in the way that is recommended in NHS clinics. Participants will be allocated to groups randomly. The feasibility of MAP will be assessed through estimations of recruitment and retention rates, the sensitivity and reliability of the outcome measures, the intensity and frequency of the trial, the usability of the MAP app (beta version), and the burden of the assessments for the children and parents. Discussion This feasibility randomised controlled trial will establish the acceptability and estimate the power of the MAP intervention to improve early word learning in children with ASD. In the longer term, this research will help us develop an app for parents or carers of children with ASD to design their own songs and implement their own individualised MAP. Trial registration ISRCTN, ISRCTN12536062. Registered on 26 June 2019.


Autism ◽  
2021 ◽  
pp. 136236132110421 ◽  
Author(s):  
Valérie Courchesne ◽  
Rackeb Tesfaye ◽  
Pat Mirenda ◽  
David Nicholas ◽  
Wendy Mitchell ◽  
...  

Opportunities to communicate first-person perspectives are essential for self-determination. However, many autistic youth are excluded from sharing their perspectives, specifically those who are minimally verbal or with lower intellectual functioning. Current challenges to capturing their voices include a lack of appropriate inclusive methodologies. Propose an inclusive strength-oriented method to capture first-person perspectives of autistic adolescents. Our protocol (“Autism Voices”) includes a pre-interview survey and semi-structured interview using universal design strategies. It was piloted with 33 participants who were representative of diverse language and cognitive abilities. A coding scheme was developed to identify communicative acts used by participants and mitigation strategies used by interviewers to enhance communication. Interviewer strategies that enhanced communication included question formulation, use of pictures, offering various output modalities, and flexible implementation of the protocol. Non-verbal and alternative communication responses (e.g. choosing to not respond) were informative to youth’s lived experience, especially for minimally verbal participants. Overall, our results highlight that communication goes beyond verbally answering questions and that participants’ unconventional communication conveyed rich information. Autism Voices provides a promising method to promote the inclusion of autistic youth in research. Lay Abstract The perspective of autistic individuals is often left uncaptured, and as a result they are often excluded from making decisions that impact them. Conventional communication can be challenging for many autistic individuals, especially those who are minimally verbal or who have an associated intellectual disability. Currently, a lack of appropriate methods to capture voices across the spectrum is a barrier. In the present study, we developed the Autism Voices protocol using universal design principles to capture the perspectives and experiences of autistic youth with a range of language or intellectual abilities. This protocol was then used with 33 autistic youth aged 11 to 18 years. A scoring rubric was developed to capture the unconventional communication used by the participants and the mitigation strategies used by interviewers to facilitate the interview. Many components of the protocol were found to effectively facilitate communication between the participant and interviewer, including the use of picture cards to support verbal questions/prompts, the fact that participants could respond with their preferred communication methods (writing, texting, pointing), and the fact that interviews were applied flexibly to adapt to each participant. Unconventional communication and mitigation strategies were mostly observed in interviews with minimally verbal individuals, but a fine-grained analysis showed participants were still communicating something through this unconventional communication. Our protocol could help promote the inclusion of more autistic individuals in research and showed that unconventional modes of communication like echolalia provide an understanding that participants’ are invested in conversations and certain topics are more meaningful than others.


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